Self-Reported Dietary Habits and Barriers Among First Responders

Firefighters (FFs) and law enforcement officers (LEOs) have a high, lifestyle-related, risk for health conditions such as cardiovascular disease (CVD). Nutritional intervention has been identified as a critical area to improve these risk factors. However, there are limited data regarding the dietary habits and barriers of FFs and LEOs. PURPOSE: This study aimed to investigate the dietary habits of first responders and the factors or barriers influencing them. METHODS: Cross-sectional data were obtained from 21 first responders regarding nutritional habits, factors, and barriers via validated paper-based questionnaires which include; the Perceived Barriers to Healthy Eating, Food Choice Questionnaire, and Rapid Eating Assessment for Participants - Short Version. The questionnaire data were analyzed using SPSS version 29 software. Shapiro-Wilk Test was used to assess normality for all continuous variables. Categorical data are reported as frequencies (n) and total percentages. A chi-square analysis was also used to determine independence (p\u3c0.05) between the groups. RESULTS: A total of 21 FFs (n=7) and LEOs (n=13) (age = 37.7±2.1; height = 180.8±1.4 cm; weight = 94.3±2.1 kg) completed the questionnaires. Commonly reported barriers to healthy eating included busy lifestyles (n=18, 85.7%), irregular working hours (n=12, 61.9%), cost (n=8, 38.09%), and willpower (n=10, 47.6%). Overall, 17 (80.9%) of the respondents placed importance on consuming nutritious food, and 9 (42.8%) placed high importance on having easily accessible food options; 18 (85.7%) emphasized the importance of high protein content, yet 9 (42.8%) followed a high protein diet, while 11 (52.3%) did not follow any particular diet, and 15 (71.4%) reported a willingness to change their eating habits to be healthier. The chi-square analysis revealed no significant differences between groups. CONCLUSION: The cohort of FFs and LEOs appear to be knowledgeable regarding what food to consume and value healthy eating. However, busy lifestyles, irregular shift work, cost of food, and willpower are perceived barriers that may challenge first responders when practicing good dietary behaviors, despite the majority expressing the willingness to change their current dietary habits to healthier ones. On the whole, these data provide insight into the barriers experienced by first responders and may aid in further investigation of the implementation of healthy eating strategies in these populations

Free-living dietary intake in tactical personnel and implications for nutrition practice: a systematic review

Tactical personnel (including military, law enforcement, and fire and rescue) are responsible for ensuring national and public safety. Dietary intake is an important consideration to support optimal health and performance. The aims of this systematic review were to: (1) describe the reported free-living dietary intake (energy and macronutrients) of tactical personnel, and (2) describe the practical implications of reported dietary intakes to support the physical and dietary requirements of tactical personnel. A systematic search of databases (MEDLINE, EMBASE, CINAHL and Web of Science) was conducted following the PRISMA guidelines. English and full text research articles were identified and screened against inclusion and exclusion criteria. Demographic and dietary intake data were extracted, tabulated, and synthesized narratively. The quality of the studies was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Twenty-two studies (15 military, 4 law enforcement, and 2 fire and rescue) were eligible to inform this review. The volume of evidence suggested that tactical personnel met dietary protein and exceeded dietary fat recommendations but failed to meet energy and carbohydrate recommendations. Therefore, practical approaches to support optimized energy, fat and carbohydrate intake in tactical personnel is important

Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost

Background: Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. Objective: The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. Design: A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre−post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Participants: Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. Main outcome measures: The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Statistical analyses performed: Independent samples t-tests and χ2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ2 used for the plate waste analysis. Significance was assessed at P\u3c0.05. Results: This study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0.005) and protein (52 g/day vs 66 g/day, P=0.003) intake, as well as energy and protein intake as a percentage of requirements (63% vs 75%; P=0.024 and 65% vs 85%; P=0.011, respectively). Total mean plate waste decreased from 29% (traditional foodservice model) to 12% (room service) (P Conclusions: A patient-centered foodservice model, such as room service, can improve patient nutritional intake and enhance patient satisfaction in a budget constrained health care environment

Bedside Menu Ordering System increases energy and protein intake while decreasing plate waste and food costs in hospital patients

This study aimed to evaluate the impact of changing from a traditional paper menu ordering system (TM) to a BMOS on the key outcome measures of nutritional intake, plate waste, patient and staff satisfaction and patient food costs

Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review

Aim: Hospital foodservices provide an important opportunity to deliver valuable dietary support to patients, address hospital-acquired malnutrition risk and enhance patient satisfaction. Modifying the meal ordering process through the adoption of technology may actively engage patients in the process and provide an opportunity to influence patient and organisational outcomes. This systematic review was undertaken to evaluate the impact of electronic bedside meal ordering systems in hospitals on patient dietary intake, patient satisfaction, plate waste and costs. Methods: A systematic search following PRISMA guidelines was conducted across MEDLINE, CINAHL, EMBASE and Web of Science for randomised controlled trials and observational studies comparing the effect of electronic bedside meal ordering systems with traditional menus on dietary intake, patient satisfaction, plate waste and cost. The quality of included studies was assessed using the Quality Criteria Checklist for Primary Research tool. Results: Five studies involving 720 patients were included. Given the heterogeneity of the included studies, the results were narratively synthesised. Electronic bedside meal ordering systems positively impacted patient dietary intake, patient satisfaction, plate waste and costs compared with traditional menus. Conclusions: Despite the increase in healthcare foodservices adopting digital health solutions, there is limited research specifically measuring the impact of electronic bedside meal ordering systems on patient and organisational outcomes. This study highlights potential benefits of electronic bedside meal ordering systems for hospitals using traditional paper menu systems, while also identifying the need for continued research to generate evidence to understand the impact of this change and inform future successful innovations

Are increases in skeletal muscle mass accompanied by changes to resting metabolic rate in rugby athletes over a pre-season training period?

Optimising dietary energy intake is essential for effective sports nutrition practice in rugby athletes. Effective dietary energy prescription requires careful consideration of athletes’ daily energy expenditure with the accurate prediction of resting metabolic rate (RMR) important due to its influence on total energy expenditure and in turn, energy balance. This study aimed to (a) measure rugby athletes RMR and (b) report the change in RMR in developing elite rugby players over a rugby preseason subsequent to changes in body composition and (c) explore the accurate prediction of RMR in rugby athletes. Eighteen developing elite rugby union athletes (age 20.2 ± 1.7 years, body mass 101.2 ± 14.5 kg, stature 184.0 ± 8.4 cm) had RMR (indirect calorimetry) and body composition (dual energy x-ray absorptiometry) measured at the start and end of a rugby preseason ∼14 weeks later. There was no statistically significant difference in RMR over the preseason period (baseline 2389 ± 263 kcal·day−1 post 2373 ± 270 kcal·day−1) despite a significant increase in lean mass of +2.0 ± 1.6 kg (P < 0.01) and non-significant loss of fat mass. The change in RMR was non-significant and non-meaningful; thus, this study contradicts the commonly held anecdotal perception that an increase in skeletal muscle mass will result in a significant increase in metabolic rate and daily energy needs. Conventional prediction equations generally under-estimated rugby athletes’ measured RMR, and may be problematic for identifying low energy availability, and thus updated population-specific prediction equations may be warranted to inform practice

Increasing protein distribution has no effect on changes in lean mass during a rugby preseason

Increasing the frequency of protein consumption is recommended to stimulate muscle hypertrophy with resistance exercise. This study manipulated dietary protein distribution to assess the effect on gains in lean mass during a rugby preseason. Twenty-four developing elite rugby athletes (age 20.1 ± 1.4 years, mass 101.6 ± 12.0 kg; M ± SD) were instructed to consume high biological value (HBV) protein at their main meals and immediately after resistance exercise while limiting protein intake between meals. To manipulate protein intake frequency, the athletes consumed 3 HBV liquid protein supplements (22 g protein) either with main meals (bolus condition) or between meals (frequent condition) for 6 weeks in a 2 x 2 crossover design. Dietary intake and change in lean mass values were compared between conditions by analysis of covariance and correlational analysis. The dietary manipulation successfully altered the protein distribution score (average number of eating occasions containing > 20 g of protein) to 4.0 ± 0.8 and 5.9 ± 0.7 (p < .01) for the bolus and frequent conditions, respectively. There was no difference in gains in lean mass between the bolus (1.4 ± 1.5 kg) and frequent (1.5 ± 1.4 kg) conditions (p = .91). There was no clear effect of increasing protein distribution from approximately 4-6 eating occasions on changes in lean mass during a rugby preseason. However, other dietary factors may have augmented adaptation. © 2016 Human Kinetics, Inc